By Robert Reilly Jr., Mark Perazella
Essential Evidence-Based info for universal medical Encounters
"This is especially beneficial for services who want a quick evaluation of fluid, electrolyte, and acid-base issues with out soliciting for in-depth details. historical past information regarding pathophysiology and references aren't integrated, yet should not wanted. This makes the ebook targeted and particularly diverse from different on hand assets at the subject. three Stars."-- Doody's evaluation provider
Make feel of acid-base and electrolytes with this compact, on-the-go guide--filled with medical proof, figures, and data.
In this ultra-convenient source, the authors have distilled down the main correct insights from their acclaimed textual content Nephrology in 30 Days , providing you with an entire, but concise evaluate of acid-based and electrolytes--supported through evidence-based findings.
You'll locate at-a-glance tables and a bulleted layout that places key diagnostic and medical info correct at your fingertips. This one-stop consultant will get you in control at the significant concerns in acid-base and electrolyte disturbances, from metabolic acidosis to serum calcium problems. it is the excellent medical significant other to extra in-depth acid-base texts--one that is going past academic rules to target the genuine international of medical medication and sufferer management.
- The ideal moveable mind for the wards
- Vital proof and figures each person forgets to recollect
- Presented in easy-access tables
Read or Download Lange Instant Access: Acid-Base Fluids and Electrolytes PDF
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Additional resources for Lange Instant Access: Acid-Base Fluids and Electrolytes
Sources of Na+ Loss 50 General Approach to the Volume Depleted Patient 51 2–28. Approach to the Patient with Decreased ECF Volume 51 General Treatment of the Volume Depleted Patient 52 2–29. Treatment of the Patient with Decreased ECF Volume 52 2–30. Amount and Rate of Repletion Based on Clinical Situation 52 2–31. Choices of ECF Volume Expanders 53 23 24 DISORDERS OF Na+ BALANCE INTRODUCTION TABLE 2–1: Basics of Na؉ Balance Disorders of ECF volume are due to disturbances in Na+ balance ECF volume control depends on regulation of Na+ balance, which reflects the Na+ content of the body Na+ concentration reflects water balance, not Na+ balance or content.
Glucocorticoids circulate at much higher concentration than mineralocorticoids. It is type-2 11 β-HSD that ensures a specific mineralocorticoid effect and not the receptor itself • The mineralocorticoid receptor is expressed in DCT, while type-2 11 β-HSD is expressed in the later part of the DCT—DCT2 • PHA II is an autosomal dominant disease of activated NCC characterized by hypertension, hyperkalemia, and thiazide sensitivity (see Table 6–44) • Mutations in two members of the WNK—WNK1 and WNK4—cause the disease Abbreviations: DCT, distal convoluted tubule; NCC, Na+-Cl− cotransporter; ENaC, epithelial Na+ channel; HSD, hydroxysteroid dehydrogenase; PHA II, Pseudohypoaldosteronism type II; WNK, with no lysine (K) kinase family DISORDERS OF Na+ BALANCE TABLE 2–11: Cortical Collecting Duct CCD reabsorbs 1–3% of filtered Na+ load • Na+ enters the CCD cell via ENaC and exits through the basolateral Na+-K+ ATPase • ENaC is composed of three subunits (α, β, δ ) • Aldosterone and AII increase ENaC abundance in CCD • Liddle’s syndrome is an autosomal dominant disorder characterized by early onset hypertension, hypokalemia, and metabolic alkalosis (see Table 7–15) • Results from mutations in α- and β-ENaC subunits that increase ENaC activity Abbreviations: CCD, cortical collecting duct; ENaC, epithelial Na+ channel; AII, angiotensin II TABLE 2–12: Medullary Collecting Duct In IMCD Na+ enters the cell via ENaC and a cyclic GMP gated cation channel that transports Na+, K+, and NH4+ The cyclic GMP gated cation channel is inhibited by natriuretic peptides, the major regulator of Na+ transport in IMCD Abbreviations: IMCD, inner medullary collecting duct; ENaC, epithelial Na+ channel; GMP, guanosine monophosphate 33 34 DISORDERS OF Na+ BALANCE TABLE 2–13: Natriuretic Peptides Natriuretic peptides are a family of proteins • ANP • Long acting atrial natriuretic peptide • Vessel dilator • Kaliuretic peptide • BNP • CNP • Urodilatin Three types of NPR exist NPR-A and NPR-B are isoforms of guanylate cyclase NPR-A catalyze the conversion of GTP to cyclic GMP NPR-B may be a specific receptor for CNP Atrial natriuretic peptide acts through NPR-A Sites of natriuretic peptide production • ANP—cardiac atrium • BNP—cardiac ventricles • CNP—endothelial cells • Urodilatin—distal tubule of kidney Natriuretic peptides protect against ECF volume expansion, especially in congestive heart failure Abbreviations: ANP, atrial natriuretic peptide; BNP, brain-type natriuretic peptide; CNP, C-type natriuretic peptide; NPR, natriuretic peptide receptors; GTP, guanosine triphosphate; GMP, guanosine monophosphate; ECF, extracellular ﬂuid DISORDERS OF Na+ BALANCE 35 DISORDERS ASSOCIATED WITH INCREASED TOTAL BODY Na؉ (ECF VOLUME EXPANSION) Hypervolemic states (increased ECF volume) are associated with increased total body Na+ and edema that occurs with or without hypertension.